An evaluation of systemic inflammatory response syndrome signs in the Sepsis Occurrence in Acutely ill Patients (SOAP) study

Abstract

Although common in the ICU, SIRS has prognostic importance in predicting infections, severity of disease, organ failure and outcome.

Quick Sepsis-related Organ Failure Assessment, Systemic Inflammatory Response Syndrome, and Early Warning Scores for Detecting Clinical Deterioration in Infected Patients outside the Intensive Care Unit

“…Previous consensus definitions included the Systemic Inflammatory Response Syndrome (SIRS) criteria, which consisted of temperature, white blood cell count, heart rate, and respiratory rate (3,4). However, SIRS criteria have been criticized for their poor specificity, with 90% of intensive care unit (ICU) patients and 50% of general ward patients meeting the criteria at some point during their hospitalization (5)(6)(7). This led the authors of the 2016 sepsis guidelines to use a more data-driven approach to developing the definition of sepsis (8,9).…”

The new sepsis consensus definitions: the good, the bad and the ugly

“…In fact, SIRS is important [5] as a descriptor for infected and noninfected patients sharing similar characteristics [4]. It is a sensitive tool for the early recognition of risk for mortality and morbidity [6], identifying patients with increased prevalence of infections [7,8] severity of disease [5,8], organ failure [5] and mortality [5,7,9]. SIRS has been incorporated as inclusion criteria in many sepsis trials [10] and used in quality improvement initiatives and management bundles to improve sepsis care [11].…”

Definition of Sepsis and Non‐Infectious SIRS

“…However, not all have considered the SIRS criteria useful, arguing that they are too sensitive and non-specific to be of any real use in clinical diagnosis or in the clinical trial setting [6]. Indeed, most intensive care unit (ICU) patients and many general ward patients meet the SIRS criteria [7][8][9][10][11]; in the recent Sepsis Occurrence in Acutely ill Patients (SOAP) study, 93% of ICU admissions had at least two SIRS criteria at some point during their ICU stay [11]. In addition, a ''diagnosis'' of SIRS provides no real information regarding the underlying disease process; each of the SIRS criteria can be present in many conditions.…”